PDD

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Pervasive spectrum disorders

• Tammy Marie Baker RN DOCS

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299.80 Pervasive Developmental Disorder

• 299.80 Pervasive Developmental Disorder, Not
  Otherwise Specified (PDD-NOS)This category should
  be used when there is a severe and pervasive
  impairment in the development of reciprocal
  social interaction or verbal and nonverbal
  communication skills, or when stereotyped
  behavior, interests, and activities are present,
  but the criteria are not met for a specific
  pervasive developmental disorder, schizophrenia,
  schizotypal personality disorder, or avoidant
  personality disorder. For example, this category
  includes "atypical autism" --presentations that
  do not meet the criteria for autistic disorder
  because of late age of onset, atypical
  symptomatology, or sub threshold symptomatology,
  or all of these.

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pervasive developmental disorders (PDD)

• Group of disorders characterized by delays in the
  development of socialization and communication
  skills.
• Symptoms as early as infancy, typical age of
  onset is before 3 years of age
• Symptoms may include problems with understanding
  and using language difficulty relating to
  people, objects, and events
• Characteristics include difficulty with changes
  in routine or familiar surroundings, and
  repetitive body movements or behavior patterns
  evidenced
• Autism is the most characteristic and best
  studied PDD
• Other Classifications of PDD include Asperger's
  Syndrome, Childhood Disintegrative Disorder, and
  Rett's Syndrome
• Abilities, intelligence, and behaviors vary
  widely Children with PDD
• Some children do not speak others speak in
  limited phrases or conversations, and some have
  relatively normal language development.
• Repetitive play skills and limited social skills
  are generally evident
• Unusual responses to sensory information, such as
  loud noises and lights, are also common.
• , Symptoms and Treatment A person is diagnosed
  with PDD if they have some behaviors seen in
  autism but dont meet the full criteria for
  having an Autistic Disorder

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Treatment

• There is no known cure for PDD
• Medications are used to treat specific behavioral
  problems
• Therapies are individualized to child's needs
• IEP for individual child's needs

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Diagnosis of PDD

• There are no blood tests or brain tests (EEG, CAT
  scan, MRI, PET scan) that conclusively identify
  the presence of autism.
• Diagnosis is based on DSM criteria and
  multidisciplinary Evaluations

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Multidisciplinary Diagnostic Team Diagnos

• Child psychologists
• Child psychiatrists
• Speech pathologists
• Developmental pediatricians      
• Pediatric neurologists
• Audiologists
• Physical therapists
• Special education teachers

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Evaluation Process Autism Spectrum Disorder
Diagnosing an autism spectrum disorder is not a
brief process. There is no single medical test
and multiple evaluations and tests are
necessary. Parent interview In the first phase
of the diagnostic evaluation, you will give your
doctor background information about your childs
medical, developmental, and behavioral history.
If you have been keeping a journal or taking
notes on anything that concerned you, turn over
that information. The doctor will also want to
know about your familys medical and mental
health history. Medical exam The medical
evaluation includes a general physical, a
neurological exam, lab tests, and genetic
testing. Your child will undergo this full
screening to determine the cause of his or her
developmental problems and to identify any
co-existing conditions. Hearing test Since
hearing problems can result in social and
language delays, they need to be excluded before
an autism spectrum disorder can be diagnosed.
Your child will undergo a formal audiological
assessment where he or she is tested for any
hearing impairments, as well as any other hearing
issues or sound sensitivities that sometimes
co-occur with autism. Observation Developmental
specialists will observe your child in a variety
of settings to look for unusual behavior
associated with the autism spectrum disorders.
They may watch your child playing or interacting
with other people. Lead screening Because lead
poisoning can cause autistic-like symptoms, the
National Center for Environmental Health
recommends that all children with developmenta l
delays be screened for lead poisoning.
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prognosis and interventions

• Early intervention is essential
• IEP for School
• Supportive Educational and Medical services are
  individualized
• Life expectancy is not affected

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other evaluations

• Speech and language evaluation A speech
  pathologist will evaluate your child's speech and
  communication abilities for signs of autism, as
  well as looking for any indicators of specific
  language impairments or disorders.
• Cognitive testing Your child may be given a
  standardized intelligence test or an informal
  cognitive assessment. Cognitive testing can help
  differentiate autism from other disabilities.
• Adaptive functioning assessment Your child may
  be evaluated for their ability to function,
  problem-solve, and adapt in real life situations.
  This may include testing social, nonverbal, and
  verbal skills, as well as the ability to perform
  daily tasks such as dressing and feeding him or
  herself.
• Sensory-motor evaluation Since sensory
  integration dysfunction often co-occurs with
  autism, and can even be confused with it, a
  physical therapist or occupational therapist may
  assess your child's fine motor, gross motor, and
  sensory processing skills.

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What does PDD look like?
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the five Pervasive Developmental Disorders

• Listed below are the diagnostic criteria for the
  five Pervasive Developmental Disorders (PDDs),
  also known as Autism Spectrum Disorders (ASDs),
  as defined by the Diagnostic and Statistical
  Manual of Mental Disorders - Fourth Edition
  (DSM-IV), published by the American Psychiatric
  Association, Washington D.C., 1994, the main
  diagnostic reference of mental health
  professionals in the U.S.
• Autistic Disorder
• 299.80 Pervasive Developmental Disorder, Not
  Otherwise Specified
• 299.80 Asperger's Disorder
• 299.80 Rett's Disorder
• 299.10 Childhood Disintegrative Disorder

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299.10 Childhood Disintegrative Disorder
299.10 Childhood Disintegrative Disorder A.
Apparently normal development for at least the
first 2 years after birth as manifested by the
presence of age-appropriate verbal and nonverbal
communication, social relationships, play, and
adaptive behavior. B. Clinically significant loss
of previously acquired skills (before age 10
years) in at least two of the following
areas (1) expressive or receptive language (2)
social skills or adaptive behavior (3) bowel or
bladder control (4) play (5) motor skills C.
Abnormalities of functioning in at least two of
the following areas (1) qualitative impairment
in social interaction (e.g., impairment in
nonverbal behaviors, failure to develop peer
relationships, lack of social or emotional
reciprocity) (2) qualitative impairments in
communication (e.g., delay or lack of spoken
language, inability to initiate or sustain a
conversation, stereotyped and repetitive use of
language, lack of varied make-believe play) (3)
restricted, repetitive, and stereotyped patterns
of behavior, interests, and activities, including
motor stereotypies and mannerisms DD. The
disturbance is not better accounted for by
another specific pervasive developmental disorder
or by schizophrenia.
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299.80 Rett's Disorder (or Rett Syndrome)

• A. All of the following
• (1) apparently normal prenatal and perinatal
  development
• (2) apparently normal psychomotor development
  through the first 5 months after birth
• (3) normal head circumference at birth
• B. Onset of all of the following after the period
  of normal development
• (1) deceleration of head growth between ages 5
  and 48 months
• (2) loss of previously acquired purposeful hand
  skills between ages 5 and 30 months with the
  subsequent development of stereotyped hand
  movements (i.e., hand-wringing or hand washing)
• (3) loss of social engagement early in the course
  (although often social interaction develops
  later)
• (4) appearance of poorly coordinated gait or
  trunk movements
• (5) severely impaired expressive and receptive
  language development with severe psychomotor
  retardation

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Educational graph of PPd-NOS Placement PDPlacemen
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statistics the Interactive Autism Network (IAN)
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